Medicare For All? Be Very Careful What You Wish For...

A new analysis states that Bernie Sander’s Medicare For All idea would cost $34.7 trillion dollars over 10 years. Ummm… We’re complaining about spending $3 trillion a year on health care right now? Beyond the sticker shock of that number, there is the most fundamental fact that government, which in our “of the people, for the people, and by the people” democracy is supposed to be made up of citizens taking turns at serving as public servants, was never designed to run businesses, let alone take over a broken health care system. How does that make any sense?

To me, government is a revolving group of citizens who are our neighbors elected and tasked with collecting our taxes, then listening to us on how we believe those taxes should best be spent on things like safe infrastructure and law enforcement, as well as lawmaking based on our feedback. If I had my way, government wouldn’t be involved in anything else. Education, health care and all of the other things government is getting involved in would be required to run as lean and mean as our main street small businesses have to. (And those main street small business owners, by the way, would be my choice to represent me in Washington D. C. every time.)

It is almost as if we’ve become weary, so Medicare For All is starting to sound like an easy way out of the mess we’ve all had a hand in creating when it comes to our U.S. health care system. Believe me, after living in countries that took that “easy” way out, it is a train wreck, so be very careful what you wish for. I don’t know quite how rosy pictures are painted of those countries’ health care systems – but I do know firsthand that those stories are not true.

This is no time to give up. This is no time to give in. We’ve made this mess – together we can fix it. The first step is transparency. There are reports that consumers are not shopping as we expected they would as soon as they had skin in the game in the form of high deductibles. They, instead are just not going, or still doing what their doctor tells them instead of checking prices. Why are we surprised at this?
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​When prices are opaque and providers aren’t straightforward, oh, and big pharma is playing games with discounts, what do we expect? We haven’t yet even come close to achieving transparency in health care and are nowhere yet near the level of transparency we often take for granted in other industries. We must keep pushing for complete transparency, requiring pricing information to be in easy-to-understand English (and whatever other languages we speak). We must keep pushing for accountability. We must keep pushing for affordability. No more shell games.

In addition, we need to realize that along with this transparency, accountability and affordability, the administrative costs that have been estimated to be as high as 30% of that $3.3 trillion a year we are currently spending ought to also be slashed.
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​We also need to shift our entire health care system to a “well” rather than a “sick “paradigm. We need to figure out how to keep well, which is enormously less expensive than waiting until we are sick to seek care. Every moving part of our health care system ought to first be focused on “well,” how to achieve and maintain “well.” If our health care providers were paid to keep us “well,” and they were financially penalized, as were we, because we certainly must take responsibility in making the right choices to stay “well,” when we become sick, then we would be looking at an entirely different health care system.

As far as employer-sponsored health care, everyone in America, individuals purchasing health plans as well as small businesses, ought to be able to access the same incentives large employers do through volume-buying, and either take away the tax-incentives, or give them to all. But that means health care prices would have to be realistic and affordable in the first place. Health insurance, after all, reflects those prices.

Association Plans are a good idea in theory, but without dedicated management who know what they are doing, and appropriate checks and balances, Association Plans in the past ended up like the Obamacare Co-ops - heavy on ideals and light on business acumen ending up bankrupt or corrupt. And, they shouldn’t be controlled by government in any way, but by economies of scale and free market principles.

Finally, health insurers need to be put in their rightful place – simply as third party payers. No one in the health care system we all want and deserve ought to be practicing medicine without a license. The focus needs to move back to doctor and patient, with health insurance being a convenient way to pay for health care.

In fact, imagine if health insurers actually disappeared for a full year, just went on vacation, then it would be providers and patients figuring out quickly how to work together. Transparency, accountability and affordability would be an immediate result – or providers would go out of business! No more hiding behind health insurers. No more health insurers practicing medicine without a license. Patients would be getting the care they need at prices they could afford.

Don’t give in. Don’t give up. Keep letting your representatives in Washington, your health insurance agents, and your health care providers know what you want and need. This is no time to faint. This is no time to look at Medicare For All as an easy way out. We can do this!